Well, that was fast. A matter of days since becoming the most-hated man in America for jacking up the price of the drug Daraprim by over 5000 percent, Turing Pharmaceuticals CEO Martin Shkreli told NBC news that he would lower the price to a more reasonable level, albeit without specifying the new cost.
But even in lowering the price of Daraprim, which is used to treat the parasitic disease toxoplasmosis, a parasitic disease that can be particularly harmful for pregnant women and immunocompromised patients, Shkreli is still trying to paint himself as guileless.
At this point, his denial is almost superhuman.
In a Tuesday night phone interview with NBC News, Shkreli said the decision to reverse the price hike was made not because the decision was wrong but rather because of “the anger that was felt by people,” which is one way of referring to the massive global outrage his company sparked.
He also shrugged off the idea that he was the money-hungry villain that he so transparently seems to be: “I think in the society we live in today, it’s easy to want to villainize people, and obviously we’re in an election cycle where this is [a] very, very tough topic for people and it’s very sensitive.”
As for Hillary Clinton’s accusations of price gouging, Shkreli condescendingly told NBC News that, “It’s very hard stuff to understand,” when, in fact, biotech and infectious disease experts have weighed in on the decision in the past few days and come to the conclusion that the price hike was unjustifiable.
In the original 1979 Alien movie, one character says of the eponymous creature that is killing off the crew, “I admire its purity.” If Shkreli’s particular brand of corporate greed were not potentially deadly, it, too, would be almost admirable in its excess and precision.
In fact, by lowering the price, Shkreli is effectively conceding that his attempts to justify the hike over the past few days were deceptive—good news for patients, bad news for a man that did nothing to salvage an already tarnished public reputation. Shkreli can try to cover over his history of misdirection with a wave of his hand, but we can—and probably should—dwell on it for longer than a social media outrage cycle lasts.
Consider that if Shkreli actually believed that new research and development was necessary to develop a Daraprim alternative—if he actually felt, as he maintained on Monday, that he had the best interests of toxoplasmosis sufferers at heart—he should have kept the price at $750 a pill and produced credible research to substantiate his claim. The fact that he backtracked Tuesday and immediately made his Twitter account private is a tacit admission that these were excuses that barely papered over what seemed to be a blatant attempt to profit off of AIDS patients.
Daraprim might go back down in price but Shkreli is still, as The Daily Beast decorously put it yesterday, an asshole. And because Shkreli is not the first and won’t be the last to try to pull this same pharmaceutical stunt, it’s important not to forget his particular brand of bullshit.
In fact, Shkreli barely left us with time to fully deconstruct just how shoddy his case for the price hike actually was. Let’s not forget that a couple of days ago, the young CEO was still minimizing the effectiveness of Daraprim and attempting to portray himself as a savior for toxoplasmosis sufferers.
“This is a very, very tough disease,” he told Bloomberg Monday. “It requires a lot of attention and focus from the drug companies to partner with patients and distributors to make sure that it’s a very cared-for community.”
Shkreli also promised Monday that Turing’s revenue would allow the pharmaceutical company to develop an improved version of the drug.
“These patients deserve a company that is turning a fair profit and also developing a drug that is better for them,” he added in the Bloomberg interview.
The Daily Beast attempted to contact Shkreli multiple times via e-mail and through Twitter over the last few days to ask him to substantiate his claims that Daraprim needed to be improved. We received exactly one response: a tweet referencing a study, with no citation provided. In browsing through Shkreli’s responses to other reporters, he referenced concrete data only a handful of times, never including citations. These responses are now hidden from the public.
Before Shkreli lowered the price, however, Dr. Nick Bennett, the Medical Director of Infectious Disease and Immunology at Connecticut Children’s Hospital, helped The Daily Beast sort through Shkreli’s public attempts to justify the development of a Daraprim alternative.
It is important to note, too, as multiple infectious disease experts told The Daily Beast, that even if Shkreli genuinely wanted to develop a new toxoplasmosis drug, other funding routes would be more ethical than exploiting the same patients who suffer from the condition.
Shkreli first told The Daily Beast on Twitter that a study of two people with myasthenia gravis, an autoimmune neuromuscular disorder, showed that “both died despite treatment.” That appears to have been a reference to a 2015 study that Bennett hunted down in the journal Neurology: Neuroimmunology and Neuroinflammation.
Does this study specifically speak to a need for a new version of Daraprim? By no stretch of the imagination. The paper is a case study of just two patients, one suffering from myasthenia gravis, the other from a condition called inflammatory myopathy. Both patients developed toxoplasmic encephalitis (TE), were then treated with pyrimethamine (the generic name for in Daraprim) as well other drugs, and both patients died.
But the emphasis of the study was this: Because TE has such a “high morbidity and mortality,” it must be recognized and treated earlier.
“As earlier recognition and treatment has been reported to improve outcomes in TE, these case reports emphasize the need to consider TE in any patient receiving [the immunosuppressant] MMF who presents with new cognitive or neurologic defects,” the authors wrote.
“There’s no evidence there that says you need new agents to treat this disease,” Dr. Bennett stressed to The Daily Beast. “The message of the paper is that you should watch out for toxoplasmosis if you’re using the kind of immunosuppression that we used for these [two] patients.”
Shkreli then wrote in a now-hidden tweet that toxoplasmosis has a “20 percent real-world mortality” and that “40 percent of patients can’t tolerate [a] full course.” That tweet contained kernels of truth but it was also misleading in its presentation.
Bennett could not independently verify the mortality rate but he said it was “probably reasonable” depending on certain conditions. As for the 40 percent intolerance rate, Bennett located a reference in a 2006 paper on toxoplasmosis and HIV patients in which combined treatment with pyrimethamine and sulfadiazine (an HIV-related drug) was said to cause “adverse effects (primarily rash)” in up to 40 percent of patients.
But if the rash becomes too severe, Bennett says, physicians can simply switch to an alternative regimen of medication, and this decision would happen even more frequently if Shkreli had left the price where it was—a sign, perhaps, that Shkreli’s decision to lower the price was financially motivated after all.
Bennett reviewed more of Shkreli’s once-public statements on Daraprim and came to the following professional conclusion: “This guy does not know what he’s talking about.”
“If he really wanted to be a good guy and develop a new drug for toxoplasmosis, he could have gone about it a totally different way,” Bennett told The Daily Beast. “So for him to argue that the costs are justified to develop a toxoplasmosis drug is ludicrous.”
Even with the price reportedly on its way back down, there are lessons to be learned from Shkreli’s shoddy, cherry-picked attempt to build a case for his 5000 percent price bump.
For one, sustained public engagement with the pharmaceutical industry can, in fact, be efficacious. In the midst of the outrage directed at Shkreli and Turing, Rodelis Therapeutics lowered the price of its recently acquired tuberculosis drug Cycloserine from $10,800 for 30 capsules back down to $500. Shkreli’s Tuesday night announcement is the second victory for consumer outcry in as many days. The FDA cannot control “the prices charged for marketed drugs” but apparently Twitter can.
We could have used a similar level of social media passion for any number of cases in which generics received price hikes last year, some of them, as The Wall Street Journal reports, increasing anywhere between 1,000 and over 17,000 percent. This trend prompted a probe by lawmakers led by Senator Bernie Sanders but it did not become a trending topic on Twitter.
In many ways, Shkreli’s social media hubris and his easily debunked data were blessings in disguise. It’s rare that these price hikes have a public face, or are accompanied any sort of justification. By being so loud and so transparently uninformed on social media, Shkreli has painted a bulls-eye on his own industry.
The public loves a face to put to pressing problems. Shkreli, generously, has offered his own.